New Implants Make Total Ankle Replacement Good Choice for Many

If you’re living with severe ankle pain from arthritis, you now have more options to alleviate the discomfort. While doctors used to primarily recommend ankle fusion — which decreases joint mobility — total ankle replacement (TAR) is becoming an increasingly popular choice. Thanks to recent technological advances, this procedure offers patients the chance to maintain ankle flexibility without sacrificing long-term results, according to experts at Baptist Health Orthopedic Care.

“What’s really swung the pendulum is this fourth generation of implants,” said Justin Weatherall, M.D., a Baptist Health orthopedic surgeon who specializes in foot and ankle surgery. “We now have improved implants that last longer, and we have a solution that is eliminating pain for our patients.”

Dr. Weatherall considers a patient a good candidate for an artificial ankle joint if they have:

·      Advanced ankle arthritis (due to trauma or wear and tear)

·      Pain that persists and is not responsive to conservative treatments

·      A desire to preserve their ankle movement

·      Overall good health with adequate bone quality

·      Decided that they will not participate in high-impact sports

Generally, TAR patients are above the age of 50; however, Dr. Weatherall will perform the procedure on younger patients in certain circumstances.

Today’s Implants Are Long-Lasting

At a Baptist Health Orthopedic Care Symposium, Dr. Weatherall reviewed many of the latest generation of implants. One study that followed 500 total ankle replacement patients showed that in 98.8 percent of patients, the implant lasted two years — a critical point in determining whether an implant would have long-lasting survival. In addition, just 2.8 percent of patients needed a non-revision reoperation. The study was published in The Journal of Bone and Joint Surgery in 2023.

 “With most of the implants, we are approaching acceptable survivorship rates,” Dr. Weatherall said. “Failures tend to happen within the first two years. If we get to two years, most studies show that the patient is going to keep the implant.” Physician researchers are working on collecting more data to help differentiate between options and guide them in making the best decision for each patient, particularly since new implants are being introduced to the market regularly.

Are You a Candidate for Total Ankle Replacement (TAR)?

Patients who have any of the following conditions are not ideal candidates for TAR:

·      Uncontrolled diabetes

·      Poor blood flow, which can make wound-healing difficult

·      A bone infection such as osteomyelitis or had a suspected infection after an open ankle fracture or surgery

·      Obesity

·      Neuropathy

·      Charcot foot or ankle

·      Osteoporosis

·      A desire to participate in high-impact activities

Benefits of Minimally Invasive Ankle Surgery

At the same symposium, orthopedic surgeon Cary Chapman, M.D., who specializes in foot and ankle surgery with Baptist Health Orthopedic Care, spoke about the latest advances in minimally invasive techniques.

“We are performing foot and ankle surgery through these small incisions. Our goals are to have the same or better results as traditional surgery,” he said. “Studies show that with minimally invasive surgery there are fewer wound complications, less scarring, a faster recovery and return to work, less short-term pain and a reduction in the use of opioids.”

Dr. Chapman performs minimally invasive procedures such as bunion and hammertoe surgeries, cheilectomy surgery, calcaneal and medial lateral calcaneal surgery, sliding osteotomy and metatarsal osteotomy, among others.

“We are past the fad stage with minimally invasive surgery,” Dr. Chapman said. “This is the future.”

In addition to surgical options, physicians at Baptist Health Orthopedic Care offer biologic injections, hyaluronic acid injections and other conservative treatments, including physical therapy, braces, splints and pain management. For an appointment with a Baptist Health Orthopedic Care doctor, call 786-268-6200.

Justin Weatherall, M.D., orthopedic surgeon with Baptist Health Orthopedic Care

Cary Chapman, M.D., orthopedic surgeon with Baptist Health Orthopedic Care